Study suggests exercise can lift mood, support memory, and merits a doctor’s prescription

Researchers are examining how signals released by working muscles may affect memory, mood, and other aspects of brain function, and what that could mean for people with both mental and physical health needs.

Exercise is seen as important for brain health. Image Credit: dan quiet life / Shutterstock

A recent viewpoint in the journal Brain Health reviews how exercise may support brain health and summarizes the evidence connecting physical activity with mental health, cognition, and clinical care.

Background

Brain health includes cognitive, emotional, behavioral, and social functioning across the lifespan. It is shaped by factors such as vascular and metabolic health, inflammation, sleep, physical capacity, and social connection. Physical activity is often framed as a general wellness habit, but research indicates it may also help prevent, treat, and aid recovery from brain-related conditions. It can also complement established mental health treatments.

Biological pathways linking exercise and brain function

Brain function depends in part on vascular health, metabolic regulation, inflammatory balance, and neuroplasticity. One leading explanation is the muscle-brain axis. Exercise may affect these systems by improving cardiorespiratory and cerebrovascular function, regulating immune activity, and altering neurotrophic factors involved in learning and synaptic plasticity. When skeletal muscle contracts, it releases myokines and other signaling molecules that interact with metabolic, inflammatory, neuroendocrine, and neurotrophic pathways tied to mood and cognition. Other proposed mechanisms include better sleep and circadian regulation, lower vascular and metabolic risk, and psychological effects such as greater self-efficacy, social connection, and behavioral activation.

In a randomized trial of older adults, aerobic exercise increased anterior hippocampal volume and improved memory. Broader research also links physical activity with cognition and executive function, although some findings are observational and cannot prove cause and effect.

Exercise mimetics are experimental drugs or biologic agents designed to reproduce selected molecular effects of exercise and may one day complement depression treatment for people unable to be physically active enough. For now, they remain experimental and should not replace safe, accessible exercise.

The muscle-brain axis is one proposed route connecting exercise to brain health. Contracting skeletal muscle releases myokines that act through metabolic, inflammatory, neuroendocrine, and neurotrophic pathways linked to mood and cognition. Figure created with the assistance of ChatGPT/OpenAI

Evidence for mental health benefits

Randomized controlled trials and meta-analyses suggest that physical activity programs can reduce depressive symptoms, anxiety symptoms, and psychological distress, with some evidence of benefit for suicide-related outcomes. A network meta-analysis of randomized trials reported lower depressive symptoms with walking, jogging, yoga, and strength training. In general, stronger effects were seen with higher-intensity exercise. Prospective cohort studies have also found that higher physical activity is associated with a lower risk of depression. Dose-response analyses suggest an association even below public health recommendations, at around 75 minutes of moderate-intensity activity per week. Even so, observational studies do not show that exercise alone prevents depression.

Cognition, aging, and severe mental illness

Physical activity has been associated with a lower risk of cognitive impairment, all-cause dementia, and Alzheimer’s disease. The World Health Organization includes physical activity in its guidance for reducing the risk of cognitive decline and dementia. However, the evidence is mainly observational and does not prove that physical activity prevents cognitive impairment, dementia, or Alzheimer’s disease.

Exercise may also help people with schizophrenia, who often have high levels of sedentary behavior, cardiometabolic disease, and premature mortality. Meta-analytic findings suggest that aerobic exercise may improve overall cognition, with possible gains in working memory, attention, and social cognition. These outcomes are important because cognitive problems can interfere with daily life, while available medications have limited effects on cognition. Still, the evidence comes from a limited number of trials with modest sample sizes, so larger studies are needed. Exercise may help address psychiatric symptoms, cognition, and physical health at the same time.

Prescribing exercise in clinical practice

Exercise prescriptions should define the type of activity, frequency, intensity, duration, safety issues, barriers, and follow-up. The World Health Organization recommends 150 to 300 minutes per week of moderate-intensity aerobic activity or 75 to 150 minutes per week of vigorous-intensity activity, plus muscle-strengthening activities on at least two days each week. Brisk walking is considered moderate intensity, while running and fast cycling are examples of vigorous exercise. Advice should be tailored to a person’s baseline fitness, symptom burden, medical conditions, preferences, and access.

Safety screening matters for people who are frail or who have unstable heart or lung symptoms, recent fainting or falls, acute infection, uncontrolled pain, or other medical instability. Some people may need medical evaluation, physiotherapy input, supervised exercise, or a temporary delay before increasing activity. For most patients, a gradual approach is appropriate, starting with low-risk activity and slowly increasing duration or intensity. The plan should be reviewed over time, and adjusted if pain, dizziness, chest symptoms, severe shortness of breath, or functional decline appear.

Access and implementation

Depression, anxiety, psychosis, chronic pain, disability, poverty, caregiving duties, and unsafe surroundings can all make regular activity difficult. Collaborative, step-by-step goals and follow-up may help. Starting points could include a brief 5-minute walk or chair-based movement. Other options include physiotherapy referral, supervised group exercise, or building movement into daily routines. Healthcare workers may assess activity levels and connect patients with appropriate community exercise programs.

Access needs to be addressed alongside exercise prescribing. Without support, recommendations can widen inequalities. Funded community exercise programs, transportation help, physiotherapy referrals, supervised groups, and partnerships with recreation centers may assist people facing financial, physical, and social barriers.

Conclusion

Exercise should be prescribed as a structured part of brain health care rather than offered only as general lifestyle advice. Research suggests it can improve mood and cognition while also supporting cardiometabolic health, sleep, functioning, and quality of life. Clinicians should prescribe safe, individualized activity and help remove barriers to participation. More adequately powered research is still needed, especially to confirm cognitive benefits in people with schizophrenia.